Can I take Apixaban and Sertraline together?

You should only take apixaban and sertraline together if your doctor has prescribed both and is monitoring you. Taking them together may increase the risk of bleeding.

Why this happens

Apixaban is an anticoagulant (blood thinner) that prevents clots. Sertraline is an SSRI antidepressant which, as a side effect, can reduce the ability of your platelets to stick together.

When both medicines work to 'thin' the blood in different ways, the risk of bleeding rises.

How to know if you're having a drug interaction

You may be experiencing an interaction between apixaban and sertraline if you notice:

• Blood in your pee (urine).

• Black tarry poo (stools).

• Coughing up blood.

• Heavy nosebleeds.

• Severe headaches.

Seek medical advice immediately if you have any of these symptoms or have a fall or a head injury.

Important precautions

Depression and anxiety disorders

You may experience an increase in suicidal thoughts or the urge to self-harm when first starting sertraline or changing the dose. This is more common in young adults under 25. Contact your doctor or go to hospital immediately if you notice any changes in your mood or behaviour.

Increased bleeding risk

Taking these medicines together significantly increases your risk of serious internal bleeding. You must watch for signs like coughing up blood, vomit that looks like coffee grounds, or black, tarry stools.

Emergency surgery or injury

Because apixaban prevents blood clotting, you are at risk of life-threatening bleeding if you have a serious injury or need emergency surgery. You must carry an anticoagulant alert card at all times to inform medical staff.

Low blood sodium (hyponatraemia)

Sertraline can cause a dangerous drop in sodium levels, especially in the elderly. Seek medical help if you experience new confusion, muscle weakness, or seizures.

Food and drink warnings

Alcohol

It is best to avoid drinking alcohol while taking sertraline. Alcohol can increase the sedative effects of the medicine, making you feel more sleepy or unsteady on your feet. Additionally, alcohol can worsen the symptoms of depression or anxiety for which you are being treated.

It is best to avoid or strictly limit alcohol while taking apixaban. Alcohol can increase the risk of bleeding in your stomach and intestines. Additionally, alcohol can thin the blood, which may increase the risk of serious bleeding when combined with this medicine.

Grapefruit juice

You should avoid drinking large amounts of grapefruit juice while taking sertraline. Grapefruit can increase the level of sertraline in your blood, which may increase the risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

Sertraline can sometimes cause nervousness or tremors. Consuming high amounts of caffeine may worsen these side effects or increase feelings of anxiety. It is advisable to monitor your caffeine intake.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.